Safety and efficacy of rapid (1,000 mg in 1 hr) intravenous iron dextran for treatment of maternal iron deficient anemia of pregnancy

Lee Wong, Samuel Smith, Marisa Gilstrop, Richard Derman, Sarah Auerbach, Nicola London, Steven Lenowitz, Huzefa Bahrain, Jessica Mcclintock, Michael Auerbach

Research output: Contribution to journalArticle

Abstract

Maternal iron deficiency anemia (IDA) is associated with risk of adverse perinatal outcomes. Oral iron is recommended to reverse anemia, but has gastrointestinal toxicity and frequent non-adherence. Intravenous (IV) iron is reserved for intolerance of, or unresponsiveness to, oral therapy, malabsorption, and severe anemia (1% with hemoglobin [Hgb] levels <7 g/dL). With rare (<100 per one million) adverse events (AEs) ability to infuse a sufficient dose of low molecular weight iron dextran (LMWID) over 60 min, LMWID is an attractive option. This study demonstrated safety and efficacy of rapid IV infusion of 1,000 mg LMWID to gravidas with moderate to severe IDA. An observational treatment study of 1,000 mg LMWID administered over 1 hr for IDA in 189 consecutive, unselected second and third trimester gravidas after oral iron failure was conducted. All received a test dose of 25 mg LMWID and were monitored for AEs during the 60-min infusion. No premedication was administered unless more than one drug allergy or asthma was present in which case IV methylprednisolone was administered. All were followed through pregnancy and delivery. Monitored parameters included Hgb, mean corpuscular volume, serum ferritin, and percent transferrin saturation. About 189 subjects received 1,000 mg LMWID. No serious AEs occurred. About 2% experienced transient infusion reactions. Hgb improved by 1-1.9 g/dL in 82% and ≥2 g/dL in 24%. Second trimester treatment was not associated with greater Hgb improvement than third trimester treatment. Anemia resolved in 95%. Administration of a single large dose of IV LMWID was effective, safe, and convenient.

Original languageEnglish (US)
Pages (from-to)590-593
Number of pages4
JournalAmerican journal of hematology
Volume91
Issue number6
DOIs
StatePublished - Jun 1 2016
Externally publishedYes

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Dextrans
Anemia
Iron
Mothers
Safety
Pregnancy
Molecular Weight
Iron-Deficiency Anemias
Hemoglobins
Therapeutics
Third Pregnancy Trimester
Second Pregnancy Trimester
Drug Hypersensitivity
Erythrocyte Indices
Premedication
Methylprednisolone
Transferrin
Ferritins
Intravenous Infusions
Observational Studies

ASJC Scopus subject areas

  • Hematology

Cite this

Safety and efficacy of rapid (1,000 mg in 1 hr) intravenous iron dextran for treatment of maternal iron deficient anemia of pregnancy. / Wong, Lee; Smith, Samuel; Gilstrop, Marisa; Derman, Richard; Auerbach, Sarah; London, Nicola; Lenowitz, Steven; Bahrain, Huzefa; Mcclintock, Jessica; Auerbach, Michael.

In: American journal of hematology, Vol. 91, No. 6, 01.06.2016, p. 590-593.

Research output: Contribution to journalArticle

Wong, L, Smith, S, Gilstrop, M, Derman, R, Auerbach, S, London, N, Lenowitz, S, Bahrain, H, Mcclintock, J & Auerbach, M 2016, 'Safety and efficacy of rapid (1,000 mg in 1 hr) intravenous iron dextran for treatment of maternal iron deficient anemia of pregnancy', American journal of hematology, vol. 91, no. 6, pp. 590-593. https://doi.org/10.1002/ajh.24361
Wong, Lee ; Smith, Samuel ; Gilstrop, Marisa ; Derman, Richard ; Auerbach, Sarah ; London, Nicola ; Lenowitz, Steven ; Bahrain, Huzefa ; Mcclintock, Jessica ; Auerbach, Michael. / Safety and efficacy of rapid (1,000 mg in 1 hr) intravenous iron dextran for treatment of maternal iron deficient anemia of pregnancy. In: American journal of hematology. 2016 ; Vol. 91, No. 6. pp. 590-593.
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